Mental Illness in the 19th Century

Psychiatry is a field of research and medicine that appeared in the 19th Century. It was still in its beginnings at the time of Jerome, and the techniques it used seem chilling today.

First of all, society in those days expected that those who had pervasive behavioural disorders or whose cognitive development was delayed would be taken care of by their families. The most severe cases were hidden away, shut up in a room of the house, as much to protect the other members of the family as for their own protection. The mildest cases were integrated into society to the degree to which they could be useful: they became the “village idiots”.

In the medical and legal terminology of the day, an “idiot” was a person whose intellectual development was severely delayed. A “simpleton” or simple-minded person was one whose intellectual development was only slightly delayed. A person who was deaf and dumb, though the disability was only physical, was generally considered to be developmentally delayed because he or she couldn’t speak. A “lunatic” was a person whose behavioural disorder was so severe and pervasive that internment was necessary.

If the family could not care for someone who was mentally ill or developmentally delayed, because they were too poor or the case too severe, the afflicted person could be confined to an insane asylum. These forerunners of modern psychiatric hospitals often resembled prisons more than medical centres. It is important to understand that antipsychotic and antidepressant drugs are extremely recent inventions. In the 19th Century, apart from laudanum (an opium derivative resembling morphine) and cocaine, psychiatrists had little in the way of drugs at their disposal.

Most of the time, asylums were built in the country, for doctors believed that fresh air encouraged healing and convalescence. During the time of Jerome, these were great stone buildings, comprising multiple wings that were divided according to the type of mental illness and the severity of cases. The sexes too were strictly separated. The afflicted slept in cells on straw mattresses placed upon iron beds (or directly on the floor). At night they were locked in their cells. Restrainment methods (chains, strait-jackets) were in common use. Meals were taken in common rooms. People who refused to eat were force-fed. The baths were common too, and persons with inadequate hygiene were washed by force. The treatment of the ill was often brutal. In short, the living conditions of the inmates was in the best of cases difficult. Cases were often reported in which families withdrew their relatives from these institutions because they preferred to see them suffer at home.